A 35-year-old woman comes to the emergency department because of abdominal pain and progressive fatigue . During this time, she has noticed that her urine is darker when she wakes up in the morning. Her stool is of normal color. Five months ago, she was diagnosed with type 2 diabetes mellitus, for which she takes metformin. Physical examination shows pallor and jaundice. There is no splenomegaly. His laboratory test results are as follows: Magnetic resonance angiography of the abdomen reveals mesenteric vein thrombosis. Which of the following is the most likely pathologic renal finding in this patient?

Question

A 35-year-old woman comes to the emergency department because of abdominal pain and progressive fatigue . During this time, she has noticed that her urine is darker when she wakes up in the morning. Her stool is of normal color. Five months ago, she was diagnosed with type 2 diabetes mellitus, for which she takes metformin. Physical examination shows pallor and jaundice. There is no splenomegaly. His laboratory test results are as follows:  Magnetic resonance angiography of the abdomen reveals mesenteric vein thrombosis. Which of the following is the most likely pathologic renal finding in this patient?

Quizplus · Accepted Answer

Eductional Objective: Paroxysmal nocturnal hemoglobinuria is due to a gene defect that leads to uncontrolled complement-mediated hemolysis.  The classic triad includes hemolytic anemia (hemoglobinuria), pancytopenia, and thrombosis at atypical sites.  Chronic hemolysis can cause iron deposition in the kidney (hemosiderosis).

A 35-Year-Old Woman Comes to the Emergency Department Because of Abdominal